Provider Demographics
NPI:1578390779
Name:NAIDNUR, SRI C
Entity type:Individual
Prefix:
First Name:SRI
Middle Name:C
Last Name:NAIDNUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 CLIFFORD ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8606
Mailing Address - Country:US
Mailing Address - Phone:224-409-8960
Mailing Address - Fax:
Practice Address - Street 1:3125 CLIFFORD ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8606
Practice Address - Country:US
Practice Address - Phone:224-409-8960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant